某院复杂性尿路感染致病菌分布及抗菌药物应用情况

目的:了解某院复杂尿路感染常见致病菌的分布及抗菌药物应用情况,为临床抗菌药物的合理使用提供依据。方法:回顾性抽取2009年1月-2010年12月某院泌尿外科住院病历复杂性尿路感染,对中段尿培养及药敏试验结果进行统计,结合现阶段泌尿外科复杂性尿路感染抗菌药物的使用情况进行分析。结果:156株复杂性尿路感染致病菌中革兰阴性杆菌占69.9%革兰阳性球菌占24.3%,真菌占5.8%。革兰阴性菌以大肠杆菌最常见,占40.4%。从药敏试验得出,大肠埃希菌耐药率最低的是亚胺培南、美罗培南,其次为阿米卡星、头孢哌酮舒巴坦。产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌、肺炎克雷伯菌的检出率分别为23.80%、38.4%。革兰阳性球菌对利奈唑胺、万古霉素、替考拉宁敏感性好。β-内酰胺类抗菌药物使用占抗菌药物的首位。结论:临床在治疗复杂性尿路感染时应根据药敏试验结果正确选择抗菌药物。

Distribution of pathogenic bacteria and the use of antibiotics in complicated urinary tract infection

OBJECTIVE To analyze the distribution of the common pathogenic bacteria and the use of antibiotics in complicated urinary tract infection for clinical reference of rational use of antimicrobial agents.METHODS The medical records of patients hospitalized in the dept.of urinary surgery in our hospital from Jan 2009 to Dec antimicrobial agents 2010 were retrospectively collected for analyses of the results of mid-stream urine culture and antibiotic resistance,meanwhile,the current utilization of antimicrobial agents in the dept.of urinary surgery was analyzed.RESULTS 156 strains complicated urinary tract infection pathogens were isolated including 69.9% Gram-negative bacteria,24.3% Gram-positive bacteria,5.8% fungi.Escherichia coli were the most common among Gram-negative bacteria,accounting for 40.4%.Results from the sensitivity test comfirmed that Escherichia coli were the least resistant to imipenem,meropenem,followed by amikacin,cefoperazone/sulbactam.ESBLs-producing Escherichia coli,Klebsiella pneumoniae detection rates were 23.80%,38.4%.Gram-positive bacteria were sensitive to linezolid,vancomycin,teicoplanin.β-lactam antibiotics antimicrobial drug use accounted for the top.CONCLUSION The antibiotics should be used rationally according to the result of susceptibility test in treating patients with complicated urinary tract infection.